论文部分内容阅读
目的:探讨滚转试验(HRT)、俯曲仰头试验(BLT)及患者主观眩晕感觉(SVS)在水平半规管良性阵发性位置性眩晕(HSC-BPPV)中对于患侧定位的临床价值。方法:HSC-BPPV患者138例,其中HSC-Can 94例、HSC-Cup 44例,对所有患者先行HRT并询问患者SVS,随后行BLT。根据HRT、SVS及BLT结果,HSCCan、HSC-Cup分别采用Barbecue法、改良Kim法复位。分析分别经HRT、BLT、SVS患侧的检出率及疗效。结果:94例HSC-Can患者和44例HSC-Cup患者,分别经BLT诱发出BN和/或LN眼震81.91%、84.09%,经HRT诱发出双侧强弱不对称眼震90.43%、88.64%,SVS诉眩晕症状重侧60.64%、63.64%。经列联表χ~2检验和两两比较,HRT及BLT检出率差异无统计学意义(P>0.05),与SVS比较差异均有统计学意义(P<0.05)。排除4例经HRT、BLT、SVS均无法定位患侧的病例,将92例HSC-Can患者和42例HSC-Cup患者进行复位治疗,仅HRT阳性者首次治愈率分别为66.67%、60.00%,仅BLT阳性者分别为71.43%、66.67%,仅HRT阳性、仅BLT阳性与HRT、BLT均阳性且患侧为同侧(70.37%、62.50%)的差异无统计学意义(P>0.05),而与HRT、BLT均阳性且患侧为异侧(37.50%、30.00%)的差异有统计学意义(P<0.05)。结论:HRT为HSC-BPPV患侧定位最有效的体位检查方法,但BLT及SVS作为HSC-BPPV定位方法也具有一定的辅助诊断价值。
Objective: To investigate the clinical value of rolling test (HRT), head elevation test (BLT) and subjective vertigo (SVS) in patients with benign paroxysmal positional vertigo (HSC-BPPV). Methods: 138 HSC-BPPV patients were enrolled, including 94 HSC-Can patients and 44 HSC-Cup patients. All patients were given HRT and the patients were asked for SVS before they were given BLT. According to HRT, SVS and BLT results, HSCCan and HSC-Cup were respectively treated with Barbecue method and modified Kim procedure. The detection rate and efficacy of HRT, BLT and SVS respectively were analyzed. Results: Eighty-four patients with HSC-Can and 44 patients with HSC-Cup had abnormal nystagmus of 90.43% and 88.64 %, SVS v vertigo symptoms side 60.64%, 63.64%. There was no significant difference in the detection rates of HRT and BLT between the chi-square test and any pairwise comparisons of chi-square test (P> 0.05). There was significant difference between them (P <0.05) and SVS. Exclusion of the affected side in 4 cases of HRT, BLT and SVS, 92 cases of HSC-Can and 42 cases of HSC-Cup were treated by reduction. The first cure rates of HRT-positive patients were 66.67% and 60.00% Only BLT positive patients were 71.43%, 66.67% respectively, only HRT positive, only BLT positive and HRT, BLT positive and ipsilateral (ipsilateral 70.37%, 62.50%) were not statistically significant (P> 0.05) However, there were significant differences between the two groups (37.50%, 30.00%) with positive HRT and BLT (P <0.05). Conclusion: HRT is the most effective method for postoperative location of HSC-BPPV. However, BLT and SVS as HSC-BPPV positioning method also have some diagnostic value.